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[2] [10] There is often an unpleasant feeling in the legs that improves temporarily by moving them. [2] This feeling is often described as aching, tingling, or crawling in nature. [2] Occasionally, arms may also be affected. [2] The feelings generally happen when at rest and therefore can make it hard to sleep. [2]
Whereas stimming is a nonpharmacologic but undirected and sometimes harmful amelioration, directed therapy tries to introduce another and generally better nonpharmacologic help in the form of the following lifestyle changes, to help a person to reduce their anxiety levels: [6] regular exercise; yoga and meditation; deep breathing exercises
After identifying the possible underlying causes and the factors contributing to insomnia, the person can begin taking steps towards getting better sleep. In CBT-I these steps include stimulus control, sleep hygiene, sleep restriction, relaxation training, and cognitive therapy. Some sleep specialists recommend biofeedback as well. [2]
Additionally, lack of sleep causes increased anxiety-like behaviors and impairs the brain's ability to block out unimportant stimuli when performing tasks requiring attention. Disruptions in important brain circuits and the downregulation of proteins necessary for cognitive stability are the causes of these behavioral abnormalities. [ 30 ]
Cataplexy is the first symptom to appear in about 10% of cases of narcolepsy, [2] caused by an autoimmune destruction of hypothalamic neurons that produce the neuropeptide hypocretin (also called orexin), which regulates arousal and has a role in stabilization of the transition between wake and sleep states. [3]
Sleep onset insomnia is difficulty falling asleep at the beginning of the night, often a symptom of anxiety disorders. Delayed sleep phase disorder can be misdiagnosed as insomnia, as sleep onset is delayed to much later than normal while awakening spills over into daylight hours. [23]